When Old Scars Cause Pain: A Rare Case of Ankle Scar Causing Sciatica-Like Pain and Gait Disturbance

When we think of surgical scars, we often associate them with abdominal pain as a common complication. However, a rare case has recently been reported in Japan of an ankle scar causing sciatica-like pain and gait disturbance in a 75-year-old man.

The patient had been experiencing right sciatica-like pain from the thigh to the lower leg for over 10 years, which had resulted in a gait disturbance. He also had mild ankle pain due to osteoarthrosis. The patient had a history of an ankle injury diagnosed as a sprain and intra-articular small fracture, for which he underwent resection of the bone fragment from the anterior aspect 14 years ago. Upon examination, it was found that the surgical scar was adherent to the underlying fascia and causing radiating pain to different parts of the scar.

The surgical scar was shown to be involved in the patient’s sciatica-like pain, and to address this, a scar-fascial release technique was performed by stretching in the direction of the palpated restriction. One month after the procedure, the sciatica-like pain and gait disturbance had resolved, while the ankle pain remained mild.

This rare case highlights the myofascial meridian concept, which suggests that the fascial system connects different parts of the body and can contribute to pain and dysfunction in seemingly unrelated areas. While abdominal pain is a well-known complication of surgical scars, this case shows that surgical scars on the extremities can also have far-reaching effects.

The case also demonstrates the importance of considering surgical scars as a possible source of pain and dysfunction, even when they are not in the immediate vicinity of the affected area. Scar-fascial release techniques, such as the one used in this case, can be an effective treatment for scar-related pain and should be considered in cases where other treatments have been ineffective.

In conclusion, this rare case of an ankle scar causing sciatica-like pain and gait disturbance highlights the importance of considering surgical scars as a possible source of pain and dysfunction, even when they are not in the immediate vicinity of the affected area. The myofascial meridian concept is a useful tool for understanding the far-reaching effects of the fascial system, and scar-fascial release techniques can be an effective treatment for scar-related pain.